23 Miss. Code. R. 203-4.3 - Co-Surgeons

A. Medicaid covers the individual skills of two (2) or more surgeons when required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient's condition. In these cases, the additional physicians are not acting as assistants-at-surgery.

B. Medicaid covers co-surgeons at sixty two and one half percent (62.5%) of the Medicaid coverage for co-surgeon procedures.

C. Medicaid covers the services of two (2) surgeons of the same specialty without regard to the two (2) specialty requirement when the services are justified by medical documentation.

D. Medicaid covers the services of two (2) surgeons in different specialties when performing a specific procedure.

1. This is also applicable when the different procedures are performed through the same incision.

2. Each surgeon must report the procedure he/she performed.

E. The appropriate modifier in conjunction with the procedure code for services rendered is required to identify a co-surgeon's services.

Notes

23 Miss. Code. R. 203-4.3

Miss. Code Ann. § 43-13-121